Comparative Study of Antibiotic-Containing Polymethylmetacrylate Capsules and Beads

Abstract

Background: This study aimed at making local antibiotic therapy wider in cases of chronic suppurations by administering antibiotics which previously could not be given in this way through the conventional polymethylmetacrylate (PMMA) carrier techniques. Capsules from this material were produced with a pressing machine designed and laid out by us. The characteristics of antibiotic penetration from this novel carrier were compared to those of PMMA beads. Methods: The time-dependent outflow of amikacin, clindamycin, pefloxacin, piperacillin + tazobactam, amoxicillin + clavulanic acid and cefotaxime was examined from the capsules and the beads with standard microbiological techniques using the Micrococcus luteus ATCC9341 test strain. The diameter of the inhibitory zones was measured after 24 h incubation at 37°C and converted to µg/ml antibiotic concentrations. Results and Conclusions: Our results revealed that all antibiotics showed longer-lasting and higher concentration outflow from the PMMA capsules than from the beads. Therefore, these capsules can provide a more promising new opportunity for specific local antimicrobial treatment in cases of chronic suppurative bone and soft tissue injuries. In these cases the polymerization has already been completed and the heat does not influence the structure of the antibiotics; therefore, it can be inserted into the capsules in powder or solution form.

Polymethyl-methacrylate–sorbitol-based capsules as local drug delivery vehicles: anin vitroantibiotic elution study

“…We consider that, after radical debridement, inserting the combination of 70 w/w%:0.5 mm and 60 w/w%:0.6 mm capsules directly into the site of the infection could provide ideal and relatively even local drug concentration, giving the best possibility of killing or inhibiting the growth of bacteria. Furthermore, the removal of the capsules would not be obligatory (Börzsei et al, 2006a), since PMMA is not immunogenic (Nandi et al, 2009); however, we would nevertheless recommend the removal of the capsules 6–8 weeks after their implantation.…”

“…An ideal LADV should provide efficient therapeutic drug release at the target site over several weeks (Wu et al, 2006) and be capable of using wide range of drugs. Therefore, we have developed, manufactured and tested a PMMA—sorbitol‐based capsule system [as an improvement of that of Börzsei et al (2006a, 2006b)] as a LADV for the treatment of chronic osteomyelitis (Frank et al, 2011). BPB (Bromophenol Blue) was used as a release marker to determine the most effective combinations of wall thickness and sorbitol content.…”

Methotrexate-Loaded Polymethylmethacrylate Bone Cement for Local Bone Metastasis Therapy: Pilot Animal Study in the Rabbit Patellar Groove

“…PMMA is known as a drug delivery system for antibiotics [14] . The material has furthermore been the standard bone cement for the fixation of artificial hip joints for decades and was used in combination with various drug loadings [14,15] . It is therefore expected not to interfere with drug effects.…”

Polymethyl-methacrylate–sorbitol-based capsules as local drug delivery vehicles: a preliminary study

“…After adding the liquid monomer to the powder mix, cylindrical blocks were made. The technique used by Börzsei et al (2006a, 2006b) was further improved by using a milling machine instead of a press to prepare the capsules. Therefore, capsules were milled out from these blocks with wall thickness of 0.3, 0.4, 0.5 and 0.6 mm.…”